Pubdate: Wed, 20 Aug 2008
Source: Edmonton Journal (CN AB)
Copyright: 2008 The Edmonton Journal
Contact: http://www.canada.com/edmontonjournal/letters.html
Website: http://www.canada.com/edmonton/edmontonjournal/
Details: http://www.mapinc.org/media/134
Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites)
Bookmark: http://www.mapinc.org/topic/InSite

ARGUE IDEAS, DON'T ATTACK MD ETHICS

The Harper Conservatives have now turned on the country's doctors, 
lowering what should be a respectful and legitimate discussion about 
the wisdom of safe-injection sites for drug addicts into the gutter 
of personal attacks and name-calling. Is this really how the 
government imagines it will convince Canadians to grant it 
untrammeled majority power?

Speaking at the Canadian Medical Association's general council 
meeting in Montreal on Monday, Health Minister Tony Clement 
effectively told physicians they are acting unethically if they see 
merit in the controversial Vancouver "Insite" clinic -- which is 
operates on the principle that addicts should have access to sterile 
equipment because their addiction will drive them to self-administer 
drugs whether they have safe needles or not.

Unbelievably, Clement admitted such sites might "slow the death 
spiral" of an intravenous drug user, but argued he didn't see this as 
a "positive health outcome" because it doesn't reverse the downward 
trend. This suggests that it would be ethical, in his view, for the 
public health system to cease medical intervention in any case in 
which a downward trend cannot be halted -- which would be startling 
news indeed to doctors and patients alike in situations without long-term hope.

Almost as surprisingly, Clement's desire to turn the subject into a 
Republican-style culture-wars battleground -- note the loaded 
description of it as a "profound moral issue" -- led him to directly 
confront the CMA's current president Dr. Brian Day. Day is a man who 
might otherwise tend to sympathize with the Harper crowd, given his 
call for more openness to choice and private alternatives in the health system.

Make no mistake here: the foregoing is not intended either to reject 
all of Clement's arguments on drug policy, or even to accept in their 
entirety claims that the safe-injection clinic is an unqualified 
success. He says the clinic is not a satisfactory alternative to more 
and better treatment for addiction -- and he's absolutely right. 
Further, the implication is valid that past governments have tended 
to pretend that stopgap measures are sufficient.

Beyond our borders, we have finally begun to understand that 
humanitarian aid programs for refugees are no answer to the thugs who 
forced them to flee their homes. When it comes to domestic social 
threats, however, we are still too easily seduced by the (far 
cheaper) appearance of action.

But Clement seems to say that the safe-injection clinic was somehow 
preventing the Harper government from doing more treatment of 
"junkies" and jailing more "pushers," to use the charming language 
with which the Conservatives seek to drive wedges between good 
Canadians and their enemies.

Clearly, the political goal here is to win favour in large urban 
centres, such as Toronto and Vancouver, that are currently political 
deserts for Conservatives. The government seems to think that the 
communities with the most first-hand experience with the drug problem 
haven't noticed that the American "war on drugs" approach doesn't 
actually work. In the election that now seems certain this fall, it 
will be interesting to see whether a largely rural and suburban party 
understands the urban majority as well as it thinks it does. But in 
the meantime, all Canadians have to ask themselves why Canada's 
medical community is wrong to want to have "a positive effect on the 
poor health incomes associated with drug use," as Day put it in a 
letter to Clement.

If Clement could prove that providing sterile injection tools don't 
have such a effect, the question would be different. But until that 
happens, you have to suspect he's really only playing a variant of 
previous governments' game of using the clinic to give the illusion 
they are getting to the bottom of the underlying problem.

The Liberals made themselves look like they were on the case in 2003 
by opening it. The Conservatives hope the electorate will buy the 
same snake oil in 2008 -- by closing it again.
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MAP posted-by: Jay Bergstrom